Abstract

Background: Stroke subjects presented with greater postural instability which lead to challenge
their balance control in sensory conflict conditions. Studies have shown that deficits of
sensorimotor integration and an inability to select the appropriate sensory input are associated
with balance measures following stroke.However, limited studies have been focused to
sensorimotor integration in balance rehabilitation. Objective: Our study aimed to evaluate the
Task Oriented Training (TOT) with sensory manipulation to enhance balance and functional
mobility in chronic stroke subjects. Design: Randomized controlled pilot study. Setting:
Department of Physiotherapy in a Tertiary care Hospital. Subjects: A convenience sample
consisting of 26 hemi paretic subjects at least 6 months post stroke duration with Brunnstrom’s
recovery stage ≥5 for the lower limb and Berg Balance Score of 40 or above were randomly
assigned control group (n=13) and in experimental group (n=13). Interventions: Control group
received the conventional physical therapy and in the Experimental group received TOT with
manipulations of sensory inputs and provision of sensory conflict for the trunk and lower limb
focusing on balance and mobility were implemented for 15 sessions, 5 days a week for 3 weeks
with each session of 45-60 mints duration. Outcome measures: Dynamic Gait Index (DGI),
Timed Up and Go Test (TUGT) and Fall Efficacy Scale (FES) were analyzed before and after
the training. Results: Post training there was a significant improvement in all the outcome
measurements for both the groups. However components 3, 4 and 5 of DGI, TUGT and FES of
experimental group had a highly significant statistical difference between-group analysis with
p<.05. Conclusion:Task oriented exercises with altered sensory input was found to be effective
in improving functional mobility in terms of dynamic balance and reduction in their fear of fall
levels after a 3 week training program.